It is estimated that over 10% of the female population in the United States will be affected by breast cancer at some point in their life. Currently, breast cancer is one of the most common cancers among American women, second only to skin cancer. It is responsible for more female-related cancer deaths than any other cancer, except lung cancer. Although the incidence of breast cancer has been declining since a sharp rise in the 1980s, it is estimated that over 182,000 new cases of invasive breast cancer will be diagnosed in women in the United States, with the chance of death resulting from breast cancer at about 1 in 35. Additionally, nearly 68,000 cases of carcinoma in situ, a non-invasive, early form of cancer will be diagnosed. Despite the fact that an estimated 45,000 women may die from the disease in 2008, actual death rates have been decreasing, generally attributed to earlier detection through screening, increased education and better treatment options.
In general, there is no specific sign or symptom definitively diagnosing cancer. Many common symptoms associated with cancers, such as weight loss, fatigue and even the development of a lump in certain areas of the body can be attributed to other ailments or harmless conditions. These symptoms, however, should not be ignored and are often used by medical professionals to perform further testing. In addition, early forms of some cancers can be detected through continuous screening methods.
Early screening for detection of breast cancer can start in a person's 20s and includes regular self-palpations and complete breast examinations. Completed by a health care professional, breast examinations consist of visual inspection and palpation of the breast, arm pits and areas around the collarbone. If a suspicious lump is detected, or as part of routine screening strategy, mammography, ultrasonography or magnetic resonance imaging (MRI) may be used to provide enhanced screening and diagnostic tools. Mammography is basically a set of x-rays of the breast which helps the diagnosing physician determine the nature of any abnormalities, particularly small non-palpable lesions. In many cases, these types of tests can aid the physician in the determination of whether the abnormality is breast cancer. However, such techniques are not 100% accurate and can miss approximately 10-15% of the breast cancer cases. Definitive diagnosis of breast cancer is only accomplished through the surgical removal of the tissue, or biopsy, for further examination by a radiologist and/or pathologist.
Locating, diagnosing and removing cancerous breast tissue requires pre and post-operative considerations. If the suspicious tissue is large enough for visualization or palpation, removal is generally not difficult. Localization of small, non-palpable tissue may be more difficult and time consuming as the surgical team uses x-rays to locate the area of concern and wire markers to mark it. Using a thin hollow needle the surgical team locates the area thought to contain the suspicious tissue as identified by a radiograph. A thin wire is inserted through the hollow needle to indicate placement of tissue removal. A hook at the end of the wire can be used to prevent the wire from slipping. The hollow needle is removed and the wire is used as a guide to locate the suspicious tissue. If the placement is correct and confirmed by a second x-ray, the tissue is removed and analyzed post-operatively. Several views of the removed tissue are often taken. This aids in localization and provides for identification of certain features of the sample which may not be identified by taking a single plane of view. Even if various features are identified from the multiple views, the final orientation may not correspond with the previous views. Taking radiographic views orthogonal to the original plane of orientation of the specimen can detect features that are undetectable in the original views. Post-operative analysis helps determine if the tissue is cancerous and whether or not the surgeon removed all the cancerous tissue. Further surgical excision may be required if cancerous tissue remains.